REFERENCE TO RELATED APPLICATIONThis application is a continuation-in-part of application Ser. No. 889,228 filed July 25, 1986 now abandoned.
FIELD OF THE INVENTIONThis invention relates generally to a method and apparatus for providing a colonic lavage and particularly to a colon hydrotherapy and evacuator system suitable for use by a patient who is either having difficulty with bowel movements or has no ability at all for bowel evacuation
BACKGROUND OF THE INVENTIONMany people, particularly those who are elderly or handicapped, have substantial difficulty with bowel movements or have no ability at all to voluntarily evacuate their bowels. These people often require daily enemas and in some cases manual removal of fecal matter or even a colostomy becomes necessary. The use of conventional devices for administering enemas is inconvenient and uncomfortable for the patient, inefficient in the removal of fecal matter, and often unsanitary.
Colonic irrigation devices have been developed but have not proven to be entirely successful. Some of the prior art devices are expensive, bulky, difficult to operate and require that the patient be brought to the apparatus for treatment. The patient insertion nozzles or specula of the prior art devices are uncomfortable, often unsanitary and do not produce the motions of the lavage liquid within the colon necessary to loosen, break up and purge the fecal matter in the most efficient manner. While the patient can manually operate a few of the prior art devices with difficulty, most require operation by an attendant and in cases of incapacitated patients, the constant attention of an attendant is always required. In addition, since the attendant can not always judge when the proper amount of lavage liquid has been introduced into the patient, the patients colon is often not sufficiently cleaned.
Examples of some prior art irrigation devices are illustrated in U.S. Pat. Nos. 1,317,851 of Arnett, 2,027,588 of Hannon, 3,042,039 of Dahlstrom, and 3,771,522 of Waysilk, and 4,262,239 of Ardizzone.
SUMMARY OF THE INVENTIONBriefly described, the present invention is a colon hydrotherapy and evacuator system which includes a disposable patient insertion nozzle or speculum comprising an elongated one piece tubular body having a generally converging end for insertion into a patient's colon and an open discharge end which remains outside of the patient. A large, single longitudinal liquid passageway extends directly from the open discharge end to the converging end of the speculum and a pair of opposing nozzle openings are formed in the side of the speculum adjacent its converging end. A tubular liquid supply port defines an inlet opening that communicates with the liquid passageway adjacent the open discharge end of the speculum. The liquid supply port extends transversely from the body of the speculum adjacent the discharge end and is radially aligned with the opposed nozzle openings. A disposable, transparent discharge conduit extends from the discharge opening, through a pinch valve, and to a collection chamber. The pinch valve is adapted to collapse and release a portion of the discharge conduit closing and opening communication therethrough. The system also includes both manual and automatic control means and is mounted on a wheeled frame for portability.
In use, the speculum is inserted into the colon of a patient with the nozzle openings aligned with the widest portion of the colon. The pinch valve is actuated closing communication through the discharge conduit and lavage liquid is pumped from a liquid holding chamber through a disposable supply conduit to the inner opening of the speculum. Oxygenated air and lavage liquid are thus forced into the colon breaking up fecal matter therein. After a predetermined length of time, pumping is discontinued and the discharge conduit opened allowing lavage liquid and fecal matter to flow from the colon to the collection chamber.
Thus, it is an object of this invention to provide a colon hydrotherapy and evacuation system that is portable and that can be conveniently operated by an attendant or by the patient himself or that can operate automatically with predetermined timed cycles eliminating the need for the constant attention of an attendant even in cases of totally incapacitated patients.
Another object of the invention is to provide a colon hydrotherapy and evacuation system that exposes the colon to fresh oxygenated air and that forces lavage liquid laterally into the colon toward the hips of a patient where the colon is widest.
Still another object of the invention is to provide a colon hydrotherapy and evacuation system having a speculum with a single passageway and that has the capability of producing surges of lavage liquid at the nozzle openings of the speculum causing fecal matter to be broken up so that it can be purged from the colon.
A further object of the invention is to provide a colon hydrotherapy and evacuation system in which the parts that come into contact with the fecal matter of the patient are discarded after use eliminating the possibility of contamination remaining with the system.
Other objects, features and advantages of the invention will become apparent upon reading the following specification, when taken in conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGSFIG. 1 is a perspective illustration of the colon hydrotherapy and evacuator system showing the liquid holding chamber, the collection chamber, and the speculum and disposable conduits, with the discharge conduit extending through the pinch valve.
FIG. 2 is a side cross sectional view of the liquid holding chamber showing how the chamber is filled with liquid.
FIG. 3 is a perspective view of the pinch valve in its open configuration showing the pinch element and the placement of the resilient collapsible portion of the discharge conduit.
FIG. 4 is a side view partially in cross section of the pinch valve in its closed configuration with the pinch element retracted.
FIG. 5 is a side view partially in cross section of the pinch valve in its closed configuration with the pinch element extended against the collapsible portion of the discharge conduit.
FIG. 6 is a plan view of the speculum showing the alignment of the nozzle openings and the liquid supply port and indicating the connection of the supply and discharge conduits.
FIG. 7 shows the speculum rotated ninety degrees from the view of FIG. 6.
FIG. 8 is a plan view of the control panel showing the alternate embodiments of the means for providing air pressure to the pressure sensitive remote switch.
FIG. 9 is a perspective view of the back of the system showing the battery, battery charger, and lavage liquid filter.
FIG. 10 shows an alternate embodiment of the speculum.
FIG. 11 shows the alternate embodiment of the speculum rotated ninety degrees from the view of FIG. 9.
DETAILED DESCRIPTIONReferring now in more detail to the drawings, in which like numerals indicate like parts throughout all the views, FIG. 1 illustrates the colon hydrotherapy andevacuator system 20 which includes aliquid holding chamber 21 and acollection chamber 22. Patient insertion nozzle orspeculum 23 having atubular body 24nozzle openings 27, supply opening 26, anddischarge opening 29 is shown inserted into thecolon 34 of a patient 33. Thesupply port 26 defininginlet opening 30 is connected through aflexible supply conduit 31 to theoutlet port 89 of theliquid holding chamber 21. Theoutlet port 89 is in communication within the chamber (FIG. 2) with apump 79 that can be actuated to pump liquid from thechamber 21 to thespeculum 24.
The discharge opening 29 of thespeculum 23 is in communication with thecollection chamber 22 through a disposabletransparent discharge conduit 32. Thedischarge conduit 32 has a resilientcollapsible portion 52 as seen in FIGS. 3 through 5. The collapsible portion passes through apinch valve 36 which clamps the collapsible portion of the discharge conduit in response to being actuated, preventing the flow of material from thespeculum 23 to thecollection chamber 22.
Astand 63 for supporting theliquid holding chamber 21 includes lowerhorizontal support members 64 andvertical stanchions 66. The pinchvalve support arm 42 is rotatably connected to one of thestanchions 66 so that it can be pivoted up or down to an out-of-the-way position when not in use. Thestand 63 is provided with ahandle 68 andwheels 67 so that the system can be rolled from place to place. The control panel 69 (to be described later) is supported between the stanchions adjacent their upper ends. Additionally, FIG. 1 shows a thermometer 65 for indicating the temperature of the liquid within the holding chamber and afilter 37 connected to the collection chamber through which air within the chamber can escape as the chamber if filled.
FIG. 2 is a partial cross sectional view of the liquid holding chamber showing the internal parts thereof. It is seen to contain apump 79 which is connected through atube 82 to theoutlet port 89 which is in communication with theliquid supply conduit 31. Check valve 83 is located in the tube and is arranged to allow the flow of liquid in the direction indicated byarrow 85 but prevents the flow of liquid in the opposite direction. Thepump 79 is electrically coupled to the control circuit throughwire 81.Float valve assembly 75 is connected throughsupply pipe 74,filter 71 andsupply hose 88 to aconventional water faucet 87.Float valve assembly 75 has aspigot 84 and avalve portion 76 which is connected via connectingrod 78 to afloat 77. With this arrangement, when liquid is moved from the water faucet 87 through thehose 88, thefilter 71, and thepipe 74 to thefloat valve assembly 75, liquid will move through thefloat valve assembly 75 and out thespigot 84 until the level of the liquid within thecontainer 21 lifts thefloat 77 causing thelever 78 to pivot, thus closing thevalve 76 and terminating the movement of liquid into thecontainer 21. Thecontainer 21 is provided with a lid 73 which fits securely on top of the container.
FIGS. 3, 4, and 5 show thepinch valve assembly 36. It is comprised generally of afront portion 38 and arear portion 39 hingedly connected together along anedge 48. Thefront portion 38 has ahemicylindrical groove 46 formed therein and therear portion 39 has an opposinghemicylindrical groove 47. The grooves are positioned so that when the front and rear portions are hinged together so that they are contiguous, the hemicylindrical grooves define a cylindrical cavity through the contiguous portions. Athumb screw 44 extends through thefront portion 38 and into the threaded receivinghole 49 in therear portion 39 so that the portions can be hinged together and securely held by the screw in their closed configuration.
A pinchelement receiving hole 55 extends through therear portion 39 and laterally intersects thegroove 47. A pinch element orplunger 51 extends through thehole 55 and is attached through anattachment rod 57 to asolenoid 56. Thesolenoid 56 is in turn connected electrically to thecontrol panel 69 from which it can be actuated as described below. The cylindrical cavity defined by thegrooves 46 and 47 when the front andrear portions 38 and 39 are closed is adapted to receive the resilientcollapsible portion 52 of thedischarge conduit 32 as seen in FIG. 3. Thecollapsible portion 52 can be attached to thedischarge conduit 32 via anadapter 53. In addition, adischarge conduit 35 can be attached to the other end of theflexible portion 52 and extended to a collection chamber. When thecollapsible portion 52 is within the cavity with the front andrear portions 38 and 39 closed as seen in FIGS. 4 and 5, thesolenoid 56 can be actuated causing thepinch element 51 to plunge forward collapsing thecollapsible portion 52 against the wall of thegroove 46 as best seen in FIG. 5. This action has the effect of preventing the flow of material throughdischarge conduit 32. When thesolenoid 56 is deactuated as shown in FIG. 4, thepinch element 51 is retracted from the resilientcollapsible portion 52 which allows material to pass from thedischarge conduit 32 through thecollapsible portion 52 and to a collection chamber through thedischarge conduit 35.
FIGS. 6 and 7 show thespeculum 23 which is disposable and formed from an inexpensive plastic or like material. Thespeculum 23 comprises an elongatedtubular body 24 defining alongitudinal passageway 25 therethrough. One end of the speculum converges inwardly forming slopedside walls 28 in which a pair ofopposed nozzle openings 27 are formed. The other end of the elongated tube is open forming adischarge opening 29. A transversely extendingliquid supply port 26 defining aninlet opening 30 is attached to the elongated tube adjacent thedischarge opening 29 so that theinlet opening 30 is in communication with thepassageway 25. Theliquid supply port 26 is or can be connected toliquid inlet conduit 31 and thedischarge opening 29 can be connected to thedischarge conduit 32 as shown in FIG. 6. It will be noted thatliquid supply port 26 is radially aligned with thenozzle openings 27.
FIG. 9 is a rear perspective of the colon hydrotherapy and evacuation system showing theliquid inlet filter 71 and theinlet pipe 74. Also shown is the battery 111 which supplies power to the system and abattery charger 112 with which the battery can be charged by plugging the charger into a conventional wall outlet.
FIG. 8 shows the control panel of the system. It has battery indicator lights 91, 92, and 93 which display the status of the battery 111.Power switch 94 completes the circuit between the battery and the system when placed in its on position.Indicator light 96 is provided as a visual indication of whether the system power is on or off.Switch 97 is provided for controlling the rate of flow of liquid through theliquid supply conduit 31 to thespeculum 23 by varying the rate at which the pump operates.
The system has a manual and an automatic mode of operation. The desired mode can be chosen usingswitch 98. In the automatic mode, the pump and pinch valve are automatically cycled on and off. The length of time that the pump is on and the valve closed which results in filling the patient's colon with liquid is controlled bypotentiometer 99. The length of time that the pump is off and the pinch valve opened which results in allowing liquid to be drained from the colon through the discharge conduit is controlled bypotentiometer 101. Thus, whenswitch 98 is in the automatic position, the system automatically cycles on and off for the times indicated bypotentiometers 99 and 101. The pump also can be turned on at any time by depressingswitch 102 and turned off by releasing theswitch 102.
When theswitch 98 is in the manual position, the activation of the pump and pinch valve is not cycled automatically but rather is controlled by an operator via the remotepressure switch hose 104. The system contains a pressure activated switch (not shown) that is connected to one end of thepressure hose 104. The pump is actuated and the pinch valve closed by creating excess pressure within thehose 104 which closes the pressure activated switch. The pump can be deactivated and the pinch valve opened when the excess pressure within thehose 104 is released. The excess pressure within the hose is created by an operator of the system by blowing into amouth piece 106 connected to thehose 104 or alternately by depressing asqueeze bulb 107 that can be connected to thehose 104. In this way, an operator or the patient himself can manually determine how long the pump should remain actuated filling the colon and how long the pump should remain inactive allowing the colon to be drained.
FIGS. 10 and 11 show an alternate embodiment of thespeculum 113 having a generallytubular body 114 defining a singlelongitudinal passageway 115 therethrough. Thespeculum 113 has a generally taperedend 122 for insertion into the colon of a patient and anopen discharge end 121. A pair of opposing, generallyrectangular nozzle openings 118 are formed in the speculum body adjacent thetapered end 122 and a generallytubular inlet port 116 extends transversely from thebody 114 adjacent thedischarge end 121. Theinlet port 116 defines aninlet opening 117 that is in communication with theliquid passageway 115. Anannular flange 120 extends around the periphery of the speculum adjacent its discharge end for forming a tight fit with the discharge conduit (not shown). An annulartapered retaining collar 119 is formed in thebody 114 and near the middle portion thereof. Thecollar 119 extends generally outwardly around thebody 114 and serves to help maintain the speculum inside the colon as described below.
OPERATIONWhen using the system of FIGS. 1 through 9 to provide a colonic lavage to a patient, theliquid holding chamber 21 is filled with lavage liquid by connecting thehose 88 to a source of lavage liquid which can be a conventional sink faucet. The faucet can be adjusted in the conventional manner to provide water at a temperature that is comfortable to the patient. The temperature of the lavage liquid within the holding chamber is indicated by thermometer 65. Water flows from thefaucet 87 throughhose 88 and throughfilter 71 and into theliquid holding chamber 21 throughpipe 74 andfloat valve assembly 75. Thefilter 71 is of a standard charcoal construction which removes chlorine and other harmful chemicals from the water.
As the liquid holding chamber fills with water, float 77 is raised by thewater causing arm 78 to pivot which closes thevalve 76 stopping the flow of liquid into the container. The faucet then is turned off and thehose 88 disconnected from the system so that the system can be moved to the vicinity of a patient to be treated.
The filled holdingchamber 21 is then rolled viastand 63 to a patient who is preferably lying in a reclined position on a bed. A package containing thespeculum 23 and the disposable supply and dischargeconduits 31, 32, and 35 as well as rubber gloves and lubricating jelly is taken fromchamber 21 and the elements therein removed.Supply conduit 31 is attached at one end to thesupply inlet 26 of thespeculum 23 and connected at its other end to thesupply port 89 on theliquid holding chamber 21. Dischargeconduit 32 is connected at one end to the discharge opening 29 of thespeculum 23 and at its other end to one end of thecollapsible conduit 52 which extends through the pinch valve. The other end of the flexible conduit is connected to one end of adischarge conduit 35 and the other end of theconduit 35 is connected to thecollection chamber 22 which preferably remains in the patients room.
Thespeculum 23 is placed through the anal canal and into the colon of the patient which has a generally elliptical cross section being wider in a direction aligned with the hips. The opposed nozzle openings can be oriented so that lavage liquid enters the colon in the direction of its widest extent by aligning the inlet opening, which in turn aligned with the inner openings, with the hips of the patient. If the patient is lying on his back, thesupply conduit 31 will lie naturally across the top of the bed which insures that theliquid supply inlet 26 and consequently the alignedinner openings 27 within the colon of the patient are oriented generally parallel to the patients hips. The support arm can then be rotatably adjusted so that thepinch valve 36 is approximately even with the top surface of the bed. When using the embodiment of the speculum shown in FIGS. 10 and 11, thebody 114 of thespeculum 113 is inserted through the anal canal such that theannular collar 119 is just inside the canal opening. In this way, the resilient tissue and muscles of the anus cause the anal canal to tend to close behind thecollar 119 securely maintaining the speculum within the anal canal and colon of the patient.
With the system thus in place, thepump 79 is actuated and theresponsive pinch valve 36 closed either by the automatic timing circuit or by the patient or attendant using the remote manual pressure tube. This causes water to be pumped from the holdingchamber 21 through thesupply conduit 31 and to thespeculum 23. Initially, if the air has not been flushed from the conduits, the portion of the discharge conduit between the closed pinch valve and the speculum will fill with lavage liquid forcing the air trapped therein into the colon of the patient. This exposes the tissue of the colon to fresh oxygenated air and kills certain harmful bacteria within the colon. When thedischarge conduit 32 has been filled, lavage liquid will begin to flow into the colon of the patient as shown in FIG. 1. Because of the generally horizontal orientation of the inner openings, the lavage liquid flows laterally toward the hips of the patient where the colon is widest and not flattened by the weight of the patient.
At the end of the predetermined cycle in the automatic mode or upon release of pressure withintube 104 in the manual mode, thepump 79 will be deactuated. The pinch valve can be simultaneously opened to provide immediate discharge or can be left closed for a predetermined length of time holding the lavage liquid within the colon before it is discharged. When the pinch valve is opened, lavage liquid and loosened fecal matter within the colon flow throughnozzle openings 27 and through the discharge conduit to thecollection chamber 22. Contaminated lavage liquid is prevented from flowing through thesupply conduit 31 back to the liquid holding chamber by the one way check valve 83. As liquid fills the collection chamber, air within the chamber escapes throughcharcoal filter 37 at the top of the chamber which removes odor and bacteria from the escaping air.
A distinct advantage of the single passageway speculum is that in cases where the fecal matter is too large to pass through the nozzle openings of the speculum, the patient or attendant can actuate and deactuate the pump and pinch valve a few times in rapid succession which creates alternating surges of lavage liquid at the inner openings. This tends to break up the fecal matter so that it will fit through the nozzle openings and can be purged from the colon. This jogging action is not possible with prior art specula having two passageways because liquid always flows out through the discharge passage and can not be surged in and out to break up fecal matter that can be clogging the system. Also, the large singlelongitudinal passageway 25 extending fromnozzle openings 27 to discharge opening 29 of the speculum assures that the maximum diameter passage is formed for the fecal matter.
When the patients colon has been thoroughly cleaned, thespeculum 23 is removed,supply conduit 31 is disconnected from the holdingchamber 21,discharge conduit 32 is disconnected fromflexible conduit 52 anddischarge conduit 35 is disconnected fromflexible conduit 52 and from the collection chamber. The speculum, supply conduit and discharge conduits are then discarded. Theflexible conduit 52 can also be discarded if desired but is designed to be used several times before being replaced.
It should be understood that the embodiments of the invention described herein merely illustrated principles of the invention in a preferred form. Other modifications and variations can be made thereto without departing from the spirit and scope of the invention as set forth in the claims.